Association between craniofacial skeletal patterns and the morphology and dimensions of the sella turcica: a...

This study aimed to classify sella turcica morphologies using lateral cephalograms, analyze craniofacial skeletal pattern differences among distinct morphologies, and investigate their associations.

This retrospective study included 240 adults (120 males and 120 females; mean age, 20.0 ± 1.6 years) selected through stratified random sampling from 729 eligible records obtained between 2023 and 2024. Sella turcica morphology was classified on lateral cephalograms into four groups: normal sella turcica, anterior wall/floor abnormality, posterior wall abnormality, and sella turcica bridging. Associations between morphology groups and skeletal pattern distributions were evaluated using chi-square or Fisher-Freeman-Halton exact tests. Group differences in continuous variables were analyzed using one-way analysis of variance or Kruskal-Wallis tests with appropriate post hoc comparisons. Correlations were assessed using Pearson or Spearman coefficients. Statistical significance was set at α = 0.05.

Sagittal skeletal pattern distribution differed significantly among the four morphology groups (p < 0.001). The bridging group showed the highest proportion of skeletal Class III subjects (36.7%), whereas the anterior wall/floor abnormality and posterior wall abnormality groups were predominantly skeletal Class I and Class II, respectively. Vertical skeletal pattern distribution also differed (p = 0.030), with a higher proportion of low-angle cases in the anterior wall/floor abnormality group and normodivergent cases in the posterior wall abnormality group. Several cephalometric variables differed among groups, including FH-NPo, SNB, APDI, FH-MP, Y-axis angle, ODI, and U1-NPo. Correlations between three-dimensional sella turcica parameters and cephalometric variables were statistically significant but generally weak, with the most consistent associations involving clinoid region distances and angles.

Sella turcica bridging was more frequently associated with a skeletal Class III-associated profile and dentoalveolar compensation. Three-dimensional clinoid region parameters showed weak but significant associations with cephalometric variables, suggesting their potential value as adjunctive imaging markers in adult orthodontic assessment rather than as standalone diagnostic criteria.